Trials and Tribulations - an RCT comparing manualized family therapy with Treatment as Usual and reflections on key issues that arose in the implementation

SHIFT has been one of the largest RCTs in the field of systemic family therapy in the UK. The study took place over five years, including three major centres with fifteen Trusts and twenty-five family therapists who worked with a manualized treatment in CAMHS with adolescents who self-harmed. While the results are not available at the time of this publication, this paper will briefly describe the pre- existing factors which were helpful in developing a successful bid, clinical and managerial elements of real world research' of complex psychological processes and the construction of the manualized systemic family therapy. It also offers examples of some of the unanticipated events in the life of such a large trial.